Kulana Malama - Ewa Beach Nursing Home
General Information
UPDATEFederal Provider Number
125057
Provider Name
KULANA MALAMA
Provider Address
91-1360 KARAYAN STREET
EWA BEACH, HI 96706
EWA BEACH, HI 96706
Provider Phone Number
8086811203
Provider SSA County
20
Provider County Name
Honolulu
Ownership Type
For profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
27
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PEDIAHEALTH CORP
Date First Approved to Provide Medicare and Medicaid services
2007-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.42593
Reported LPN Staffing Hours per Resident per Day
1.22407
Reported RN Staffing Hours per Resident per Day
3.59630
Reported Licensed Staffing Hours per Resident per Day
4.82037
Reported Total Nurse Staffing Hours per Resident per Day
8.24630
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08519
Expected CNA Staffing Hours per Resident per Day
2.72568
Expected LPN Staffing Hours per Resident per Day
1.43440
Expected RN Staffing Hours per Resident per Day
1.80865
Expected Total Nurse Staffing Hours per Resident per Day
5.96873
Adjusted CNA Staffing Hours per Resident per Day
3.08407
Adjusted LPN Staffing Hours per Resident per Day
0.70829
Adjusted RN Staffing Hours per Resident per Day
1.48572
Adjusted Total Nurse Staffing Hours per Resident per Day
5.56902
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2013-03-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2012-04-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-01-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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